Rotavirus, a viral illness, is one of the most common causes of diarrhea in young children. It usually infects children ages three months to two years. It is very contagious, and almost 100% of children will have Rotavirus before they are four years old. Rotavirus infection most often occurs in the late winter and early spring. Although some children do not become very ill from this infection, it can be most serious for infants and young children who easily may become dehydrated from vomiting and diarrhea.

What are the symptoms of Rotavirus?
The first symptoms of Rotavirus are usually fever, nausea, and vomiting. Abdominal cramps and frequent, foul-smelling watery diarrhea soon follow. The fever and vomiting may last only two to three days, while diarrhea generally continues for five to nine days. A child with Rotavirus may have a cough and runny nose also.

Dehydration is the greatest threat to the health of a child with Rotavirus. This may occur when your child is vomiting and unable to keep down enough fluids, or if your child is losing fluid from frequent, watery diarrhea. Watch your child closely for any symptoms of dehydration, with include:

1. Decreased urine output
   (No wet diaper for 4 to 6 hours for an infant, or no urine out for 6 to 8 hours in a child)


2. Dry, sticky mouth and tongue


3. No tears when crying


4. Extreme thirst


5. Child is lethargic, or very fussy

Fever
Give acetaminophen or ibuprofen as directed by your doctor, a dose based on your child's weight and age.

Vomiting
Give your child very small amounts of fluid by mouth very frequently. This may help prevent dehydration without stimulating more vomiting.

Infants up to one year of age--Offer your infant small but frequent amounts (1 to 3 teaspoons) of an oral electrolyte solution (such as Pedialyte) every 10 to 15 minutes. Do not give your infant plain water. If your infant takes too much fluid too quickly, he may start vomiting again. When your infant is able to keep down these small amounts of fluid without vomiting for two hours, gradually increase the amount of fluid.

If your child is breastfed, continue to breastfeed. Do not give your older infant any solids until he has not vomited for over 8 hours. Then start with small, bland feedings, such as cereal, and slowly increase the amounts as tolerated.

Children over one year of age-Give small amounts of clear fluids, such as Pedialyte, diluted juice, "flat soda," ice chips, and Popsicles in small amounts every 15 to 20 minutes. Avoid milk and dairy products at this time. When your child keeps fluids down with no vomiting for over 2 hours, slowly increase the amounts of fluid. Do not give your child any solids until there is no vomiting for over 8 hours. Then start with a bland diet, and slowly add more food as tolerated.

Diarrhea
Infants and children can lose a large amount of fluid and quickly become dehydrated from diarrhea. Fluid replacement to prevent dehydration is the most important thing for your child. When your child is able to keep down fluids without vomiting for more than 8 hours, you may add solid foods to the diet as tolerated. Start with small amounts of bland food, such as bananas, cereal, toast, and slowly move back to your child's normal diet. Your child will let you know when he is ready for more.

When should I call the doctor?
Contact your doctor or seek medical attention if your child:

1. Has any signs of dehydration as listed above


2. Has bloody stools


3. Has vomiting or diarrhea that seems excessive to you, or persists longer than you expect


4. Is 6 months of age or younger

Melinda Henderson is a Certified Family Nurse Practitioner. She works with patients and their families at Methodist at Mt. Hawley - Pediatrics.